Healthcare News: High-risk diagnosis codes targeted in recent OIG audit

Article Overview

This article covers a recent Office of Inspector General audit involving a Medicare Advantage plan and diagnosis coding submitted for CMS risk adjustment. It explains the audit’s focus on selected high-risk diagnosis groupings, the related overpayment findings, and the compliance and refund recommendations made in the final report. The piece is relevant to coders, compliance staff, auditors, and health plan professionals who monitor documentation support and risk adjustment practices.